McDonald Denise G M, Kinali Maria, Gallagher Andrew C, Mercuri Eugenio, Muntoni Francesco, Roper Helen, Jardine Philip, Jones David Hilton, Pike M G
Oxford Radcliffe NHS Trust, UK.
Dev Med Child Neurol. 2002 Oct;44(10):695-8. doi: 10.1017/s0012162201002778.
The objective of this study was to determine the prevalence, circumstances, and outcome of fractures in males with Duchenne muscular dystrophy (DMD) attending neuromuscular clinics. Three hundred and seventy-eight males (median age 12 years, range 1 to 25 years) attending four neuromuscular centres were studied by case-note review supplemented by GP letter or by interview at the time of clinic attendance. Seventy-nine (20.9%) of these patients had experienced fractures. Forty-one percent of fractures were in patients aged 8 to 11 years and 48% in independently ambulant patients. Falling was the most common mechanism of fracture. Upper-limb fractures were most common in males using knee-ankle-foot orthoses (65%) while lower-limb fractures predominated in independently mobile and wheelchair dependent males (54% and 68% respectively). Twenty percent of ambulant males and 27% of those using orthoses lost mobility permanently as a result of the fracture. In a substantial proportion of males, the occurrence of a fracture had a significant impact on subsequent mobility.
本研究的目的是确定就诊于神经肌肉诊所的杜氏肌营养不良症（DMD）男性患者骨折的患病率、情况及后果。通过病例记录回顾，并辅以全科医生信函或在诊所就诊时进行访谈，对就诊于四个神经肌肉中心的378名男性患者（中位年龄12岁，范围1至25岁）进行了研究。这些患者中有79人（20.9%）曾发生过骨折。41%的骨折发生在8至11岁的患者中，48%的骨折发生在能够独立行走的患者中。跌倒为最常见的骨折机制。在使用膝踝足矫形器的男性患者中，上肢骨折最为常见（65%），而在能够独立活动和依赖轮椅的男性患者中，下肢骨折占主导（分别为54%和68%）。20%能够行走的男性患者和27%使用矫形器的患者因骨折而永久性丧失活动能力。在相当一部分男性患者中，骨折的发生对其后续活动能力产生了重大影响。
